What Guardians need to know about Deathcare Planning

One Guardian shared that the first thing they do when they have someone new to serve is to finalize funeral and cemetery plans so that this part is taken care of.

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Tee’s Bio

I’m so grateful to the Guardian Association of Pinellas County for the opportunity to share, from the perspective of a pre-planning advisor, what Guardians need to know about deathcare planning.

I want to preface this by reminding you that i am not a guardian, a lawyer, a financial advisor, or a funeral director. I’m grateful to share my perspective and experience as a pre-planning advisor and will stay solidly in that lane. Also, i don’t know All Things 🙂 – and if you have a question i don’t know the answer to, there’s a whole team of people i can turn to and get the answer for you.

Today we’re going to discuss our topic in two parts: 1) An Introduction to Final Arrangements and 2) Consumer Rights and Things to Know.

SECTION 1: AN INTRODUCTION TO FINAL ARRANGEMENTS

If you’ve heard me talk before, you’ve heard about the Three Windows: the three opportunities we may have to make final arrangements.

True pre-planning comes before there’s a diagnosis, accident, or other crisis. We’re making the arrangements in advance so that no one is left doing that in one of the most difficult moments we face in life.

There’s a second window that sometimes happens; if there’s a diagnosis or someone is in hospice, families may choose to put plans in place before the death occurs to give them some time to reflect on decisions before they are implemented with a funeral director and also to provide space when the death occurs to just be with loved ones and not have to worry about next steps.

The third window is at-need planning – when a death has occurred and someone is sitting with a funeral director making final decisions and payment. When a pre-plan is in place, this conference serves as a review and opportunity to make adjustments; when no plan is in place, this can be an arduous and long process.

There are multiple ways to “plan” for death. Some people just write down their wishes; others leave a pot of money in a savings account or insurance policy. Some do both. These help, but there are still questions such as, will the money set aside cover the actual costs, do the written wishes align with what the provider offers – and what other surprises might come up?

Others choose to pre-plan, which means the specific decisions are made with the chosen funeral provider, the plan is funded, and no one has to shop or do business on that horrible day. There should be no surprises. There are of course considerations for each, and when a pre-plan is in place there will still be details that need to be written down to accompany the pre-plan.

For example, you may choose and pay for your casket in advance; however, someone will need to determine what you will be wearing.

Most funeral homes will give you a planning guide that accompanies their pre-planning so that you have space to write these details down; you can also ask your pre-planning advisor for guidance on what details will be needed based on the plan you selected.

When people talk about end-of-life care decisions, they often mean for the process of dying, such as whether to be kept on life support, organ donation wishes, or comfort care in the process of dying. Also, people often think of end-of-life planning as related to assets and property – estate planning.

Many who take care of those necessary tasks still avoid the topic of care for the body and wishes related to care of the body, services, and final disposition.

When someone dies, the general process will be:

• The death occurs. A medical professional asks the next of kin or Guardian for the number to the funeral home. The funeral home sends a care team to pick up the decedent and a funeral director is assigned to oversee the care of the decedent and the coordination of details and services.
• The arrangement conference. The funeral director sets up a time to make or review the plan, discuss dates and time frames, determine final resting place for the body or ashes, review and sign paperwork, and file for the death certificates.
• Estate administration. Once the death certificates are received, the processes of estate management can begin.

Who handles final arrangements?

If you have a ward with no family and they have written out instructions, such as a pre-plan, you should have the ability to make the arrangements. However, the funeral home will defer to a next of kin if one exists and they will be required to sign off on the plan. Here are a couple of references:

• Under Florida Statute 732.804, any person can carry out a decedent’s written instructions regarding their body, funeral, and burial arrangements. As a guardian, the first step is to check if the ward left a pre-plan contract, written declaration, or other legally valid directive about their wishes for the disposition of their remains.

• If the ward did not leave written instructions, Florida Statute § 497.005 establishes a priority list for who has the legal authority to decide on (and assume financial responsibility for) the disposition of remains. As guardian, you must follow this hierarchy.
  • The order is: 1) Surviving spouse; 2) Adult (18+) child; 3) Parent; 4) Adult sibling; 5) Adult grandchild; 6) Any other person in the next degree of kinship
  • Quoted from statute:“…if no family member exists or is available, the guardian of the dead person at the time of death; the personal representative of the deceased; the attorney in fact of the dead person at the time of death; the health surrogate of the dead person at the time of death; a public health officer; the medical examiner, county commission, or administrator acting under part II of chapter 406 or other public administrator; a representative of a nursing home or other health care institution in charge of final disposition; or a friend or other person not listed in this subsection who is willing to assume the responsibility as the legally authorized person.”

It is possible for someone to designate a deathcare surrogate, pre-need agent, authority for disposition and receipt of ashes, or other directive allowing someone other than their next of kin to handle final arrangements after their death. If the client, before incapacity, executed such a document under Florida Statute 497.005(43), that person’s authority generally supersedes the guardian’s right to control the disposition of the body, though the guardian still manages the funds. This can present a point of conflict.

Another issue i’ve found is that some funeral directors say that no matter what the decedent has in place to name someone other than the next of kin to handle arrangements, even if it is done with a lawyer, they will still defer to the next of kin. This is horrible and disrespectful, but some say that is their interpretation of their responsibility – that the next of kin, no matter what the decedent’s wishes – has the authority to handle arrangements. This is especially impactful for diverse identities. Those who may be estranged from family because of their identity, such as LGBTQ+ or those those of secular identity or religious beliefs other than those of their family often want to ensure that someone they trust to honor their identity can handle the arrangements.

• For an example of such impact, see Todd’s Story.

The Death Certificates

The funeral director will ask for, if it is not already recorded in a pre-plan, some basic information for the Vital Records. This will include, based on most recent information: the full legal name of the decedent and their residential address, date and place of birth, gender (binary only), social security number, race/ethnicity, service information if they were a veteran, marital status, primary occupation, highest education level, parents names (including family names if different from married names).

In Florida we have the long form, which includes the cause of death. This information is considered medical data and is protected by HIPPA. Some places will require this form, while others will not accept it, so you will also need copies of the “short form” without the cause of death.

The fees for death certificates are determined by the county in which the person dies. You can always get more if you need them, so don’t stress about the number in that first order.

Deathcare Decisions: Options and Technologies

We had a quick discussion in the chat about things attendees had heard of – such as water cremation, mushroom suits, natural burial, freeze-dry cremation (this is Promession or Cryomation and is not available (yet) in the Untied States).

Some unique things that people can do include regarding deathcare include hiring private celebrants, natural or green burial (there is a difference!), custom monuments and memorials, private family estates and mausoleums, water cremation, composting or Natural Organic Reduction (legal in 15 states currently, but not Florida yet), anatomical donation, ocean reefs & space flights, and more.

Lots of people are curious about eco-friendly deathcare options. Here is a presentation i did for Central Florida Earth Day hosted by the Vegetarians of Central Florida:

The primary decision that needs to be made is:
Remains as ashes or remains as body?

This decision has many factors – I usually say there are EIGHT primary factors that people consider. I list these alphabetically because the order of importance and the weight of each will be different for each of us.

1. Availability of options
2. Ecological considerations
3. Emotional considerations
4. Family traditions
5. Financial / value
6. Practical
7. Religious or Spiritual requirements
8. Values

When you make pre-arrangements, almost everything can be changed later by the person who made or purchased the plan (before the death) or by the person handling arrangements (after the death).

The one factor that should be protected is your decision whether to be cremated or not. Now, some funeral directors have told me that they can change that decision after a death has occurred, but many people have asked me how to ensure that no one can change that decision. I’ve had, for example, someone whose children only wanted her money, but her religious perspective required full casketed burial and purchase of a plot. She wanted to honor that, but her kids said she could plan all she wanted but after her death they would just cremate her and keep the difference. I hear similar concerns from diverse identities who fear their next of kin, who does not accept them, will not honor their wishes.

The best answer i can give is to assign someone as deathcare surrogate and do that with a lawyer so that when the time comes that person will have some recourse if they need to assert their authority.

Remembrance Services

There are a lot of words that people use to talk about services – and many use some of these words differently or interchangeably. I won’t let my degree in English devolve us into Linguistic Relativism. 🙂 Let’s just review some general terms. And remember – there’s no “Remembrance Service Law” dictating how you do services, what order you do them in, or whether you do them at all. These should be creative, personalized, and meaningful – if that is what is desired.

• Viewing / Visitation / Calling Hours / Wake
  • in general, with a casket present
  • Viewing may refer to having the casket open, visitation with it closed
  • Usually does not have any order of service, speakers, etc.; however, some may say a rosary or other tradition they have for this time of reflection.
• RSSI (Religious, Secular, or Spiritual Identity) service or mass
  • May be at a place of worship or congregation
  • Generally officiated by a congregational leader
  • Often has prescribed elements in the relevant tradition
• Funeral, Celebration of Life, Memorial
  • Has an order of service, officiant/celebrant/clergy, people may speak, Eulogy is delivered, etc.
  • This may be combined with a religious service or may be an additional service
• Final Resting Place
  • Graveside service with lowering of the casket or entombment of the casket or urn.
  • May also be a service at a scattering, tree planting, space flight launch, commitment of body or ashes to the ocean, or other final committal of ashes or body.
• Repast or Funeral Reception
  • Food brings us together and comforts us. Many gather for a meal as part of one or more of the above, or after the conclusion of services.

Remember that with cremation you can do all of the above – including all services with the body present before a cremation. You can also choose cremation with a simple, small viewing and/or you can choose to be present at the crematory for the cremation if the provider you’ve chosen allows that.

There are unlimited unique options for personalized services.

Final Resting Place

Once the services are complete, we need to know where the casket (or just the body) or urn will be placed.

Many of those using the service of Guardians are income-constrained, so for your business clients you may need to seek economical options. Many Guardians do want to ensure that there is a permanent place that marks that their client was here on this earth and provide a dignified place to honor that life for any future friends or relatives of the client that may come looking for them in the future. I had a Guardian tell me that scattering, to them, felt like just “discarding” someone – disposing of them. They wanted another solution.

Your pre-planning advisor should be able to discuss options with you that may be more economical, such as ossuary placement or a cremorial marker.

Back to Pre-Planning: Practical Considerations

There will be two categories of costs.

On the one hand you will have the funeral home that handles care of the decedent and care of the grieving. This will include professional services, transportation, embalming or refrigeration, casket or urn, and remembrance services.

On the other, you’ll have costs associated with the final resting place. This may include cemetery costs such as professional fees, rights if inurnment/interment, vault, and memorialization. Or it may be permits for scattering, boat charters, or other costs.

It’s important to ask your clients their preference about final resting place and to make that plan early on – especially for cremation, so that you are not left holding their urn after they have passed.

You might break your cost planning for your clients out into three sections to help you as you file your costs with the court.

1. $___________________ Funeral Costs
2. $___________________ Final Resting Place
3. $___________________ Memorialization

You might include memorialization with the final resting place, or you can break it into a third cost point.

Remember that all of these can be pre-planned, pre-designed, and pre-paid.

Veterans Burial Benefits

There are six potential benefits for qualified veterans. These will help you when serving Veteran clients. You will need the DD214 (or, if discharged before 1959, other paperwork showing honorable discharge).

The benefits are:

1. Burial or inurnment at a VA Cemetery for the veteran and their spouse
2. If using a private cemetery, there is a marker that can be provided for the veteran (not the spouse)
3. Military honors
4. Flag and presentation of colors
5. Presidential certificate – keepsake for the family in honor of the veteran’s service to our country
6. Potential reimbursement for some out-of-pocket costs that can be applied for after the veteran passes.

If you work with a Dignity Memorial provider, we are honored to serve those who have served our country. When you schedule a consultation, we’ll provide a special Veterans’ Planning Guide that pulls together everything a veteran and their family need to navigate burial benefits. In addition, when a veteran is in our care we coordinate most of the benefits with the VA for you.

What is not covered in most cases are the funeral home costs such as transportation and care of the body, casket or urn, and remembrance services. Exceptions with additional benefits may be, for example, if a service member is killed in action.

According to the United Way Alice Report on Veterans, more than one quarter (27%) of veterans – that’s 4.6 million Veterans – live in a household with income below the ALICE threshold (latest report 2019). READ MORE.

When serving Veterans with limited assets it is essential to understand how to maximize the burial benefits and ensure you can maximize what the veteran is entitled to.

In addition, Dignity Memorial does many things to support our community, and one of the most impactful initiatives is the Homeless Veterans Burial Program. To learn more, visit https://www.dignitymemorial.com/veterans/homeless-veterans-program.

Here are some links you may find helpful:

• Eligibility for Veterans Burial Benefits
• VA Cemetery locator
• Burial Allowance – amounts and how to apply
• Markers, Inscriptions, and Emblems of Belief (or non-belief)

There are 10 national Cemeteries in Florida. The closest one to those in Pinellas County is Sarasota National Cemetery. When you use the map linked above you can hover over the mark for each cemetery and see if they are open for burial, just for cremation, or if they are full.

Serving Diverse Clients

Everyone deserves to be authentically honored and served by professionals who respect and affirm their identity.

Not knowing how your minority identity will be received by someone can be stressful at any time – and a very heavy burden in a time of grief. And it’s often a surprise burden – because people don’t often consider in advance that the discrimination they face every day might also be part of the deathcare journey.

Someone might fear how they will be treated after they die. For example, they may worry how their body will be treated by people who don’t respect (or outwardly distain) them, or they may worry that their body will be blessed in a tradition other than their own, or that they may be dressed inappropriately. For those sitting with a funeral professional, they may have the stress of coming out – fear of, for example, being judged, overcharged, or othered.

An affirming professional who is educated about your identity, whatever that means to you, can make all the difference. So don’t be afraid when shopping for funeral professionals to ask hard, direct questions and determine if that person – or that company – is the right company to serve you and your family.

SECTION 2: CONSUMER RIGHTS AND THINGS TO KNOW

So hopefully that gave you some good fodder for thought about planning final arrangements in advance. Let’s talk about some practical tools that will help you as consumers in funeral, cremation, and cemetery planning.

First, funeral homes, crematories, and cemeteries are mostly regulated at the state level; however, the Federal Trade Commission’s Funeral Rule outlines some specific rights for clients:

• Consumers have the right to get a price list that they can refer to during the discussion about services and merchandise before the discussion begins. They also have the right to get price quotes over the phone.
  • The price lists are often separated out to organize them. You may find your provider has:
    • General Price List – all professional services, facility fees, transportation, and other offerings.
    • Package Price List – bundled services for type or size of service
    • Casket Price List and Cremation Price List – merchandise available
    • Outer Burial Container Price List – this may be part of the Casket Price List
    • Cemetery Price List – prices related to property and, services, and professional services at the cemetery
• Funeral homes often offer “packages” of items commonly purchased for a certain purpose (such as a service with body present before cremation). The consumer has the right to itemize their selections; they don’t have to use a “package” unless that truly saves them money and provides services and merchandise they want.
• Embalming is not required. Now, embalming may be required in certain circumstances – such as entombment in a mausoleum, international flight, or service in a church or facility that doesn’t allow unembalmed bodies. The client has the right to work with the funeral home to create a plan that doesn’t require embalming if that is their preference.
• You can supply your own merchandise and the funeral home cannot charge any fee for doing that. So if your son is a carpenter and wants to make your casket, they can do that. If you purchase a casket, urn, or other merchandise separately, you take on the responsibility of storage & delivery to the funeral home when needed, and the risk of the item being received damaged.

Here’s a link to an article (LINK HERE) by the FTC with some funeral planning tips. Planning in advance takes the pressure off of some of the responsibilities they outline here, including comparing value, resisting sales pressure, and emotional spending.

Important Questions to Ask

When pre-planning, consumers should make sure they know the answers to some basic questions. If you’re working with a good pre-planning advisor, these should be addressed in the course of your conversation; however, you want to make sure you understand.

Primarily, you want to know the financial specifics (payments, fees), what guarantees there are on your investment, what the options are for portability of the plan, and any additional costs that may come up.

Regarding the additional costs, one thing i see frequently is older people who bought a plot very young – back in the days when cemeteries would go door-to-door and sell cemetery plots. The salesperson often told them (or they assumed) that everything was included so they told their families it was all taken care of. Then a loss occurs … and the family learns that not only are there additional cemetery fees (vault, cemetery service fees, headstone), but the funeral side was not taken care of (transportation and care of the body, professional fees, casket, remembrance services, etc.). This can be a surprise bill of $15,000 or more.

So, make sure you explore these topics withy your pre-planning advisor:

• What if I move – or if I die while traveling?
  • What if I move and still want to use my plan/plot here?
• Is there a discount available?
• What are the payment plan options?
• What happens if I die before the plan is paid off?
• How do I make changes to my plan?
• Can this funeral home honor or facilitate honoring my traditions and preferences?
• Are there fees, interest, or other costs?
• What if the company goes out of business?
• Are any of the items “cash advance” (price not “locked in”)?
• What costs are not covered in the plan?
• What does my family need to do when I die?
• Who has access to review/update my plans if I’m incapacitated? What about after I die?
• If your plan is backed by insurance,
  • What is the Cost of Insurance (COI)?
  • Is there and “early pay-off” period?
  • Is there a fee for early pay-off?
  • What is covered if I die while
  • making payments?

Also, ask questions that are specific to you. A good planning advisor welcomes hard questions. In fact – if my clients ask me a question i don’t know the answer to, they get a prize as a thank you for helping me learn something new. Remember that professional you’re working with should have access to a team that backs them up, so if they don’t know about something that is important to you, they should be able to find out.

Here are some examples:

• If you have religious requirements regarding cremation, can their crematory accommodate those? Can you tour the crematory in advance?
• For Veterans, does the funeral director coordinate with the VA for the flag, military honors, scheduling with the VA cemetery, etc.?
• Can they recommend a clergy member in your specific tradition or do they use a “reverend-rolodex” or recommend only their friends?
• Can they recommend a secular funeral celebrant that is Humanist Celebrant certified?
• When was the last time they did a service for a transgender person, and what training do their staff receive in serving LGBTQ+ clients?

Payment Worksheet

Make yourself a payment worksheet if your pre-planning advisor doesn’t provide you with one. This will help you clearly see and understand the payments, any interest or cost of insurance, and early payoff deadlines. In the sample below you’ll see in the blue square how to calculate whether there is any additional cost being added to the plan – simply take the amount of the payments and multiply that by the number of months/payments. Is it more than the quoted cost? If so, understand why that is and if there is any benefit to you or your client from that (such as insurance pay-off if the beneficiary passes before payment is complete).

Remember to schedule a file review with the provider at least every five years to make sure everything is up to date in the provider’s computer and in your records.

Types of Plans

In general:

You’ll be making an insurance plan or a trust plan. We’re used to hearing “irrevocable trust”, but with funeral pre-planning in most cases insurance-backed plans are used for pre-planning and trust-funded plans are for imminent need and for all cemetery plans. Any of these can be made irrevocable (we’ll talk about that in a few minutes).

There are ways to do a trust-funded pre-need plan if that is what is best for the client, but ask your planning advisor to lay out the pro’s & con’s of each to make an informed decision.

Protecting yourself from personal liability

I’m not a guardian – so you would know better than i, but i understand that some liability for guardians occurs when they sign contracts with their own name as an individual rather than with an indication of their fiduciary capacity (The Shield). Much like someone who might sign as a DPOA for someone but use their own name and not indicate POA authority. You should find out what the proper protocol is for signing as a guardian on any agreement or contract.

Another liability may be making a plan that the court later finds to be a waste of the client’s assets (The Limit) or failing to get court approval when required before committing expenses.

When to Sign a Contract

We all know that for any contract we sign we need to first understand what is covered, payments and pay-off options, and that there is no sales pressure. I have had several clients who needed to get an irrevocable contract signed “by tomorrow” because of Medicaid application deadlines – that can create urgency, of course, but there should not be pressure from your Advisor.

Your funeral professional is in sales – like all of us are. But sales in this profession is not like selling widgets. All sales should be about compassion and serving the person in front of us, but there is a next-level emotional component for people when they are talking about deathcare and often those of us in deathcare sales are serving those who are vulnerable for various reasons. If you don’t feel like your planning advisor has your best interests at heart, you have the right to ask for someone else.

And you have a right to take a breath – or a day or other time frame – before signing.

You will also likely have a “free look” or cancellation window – make sure you know what that is. For my clients, i’d rather wait three days to sign than come back together to cancel in three days.

Who can sign a pre-need contract?

You can easily come in and do a pre-need funeral, cremation, and/or cemetery contract for your client as a guardian. If they can sign for themselves, that is ideal, but if your situation doesn’t fit the traditional “person-makes-their-own-plan” scenario we can still help.

The ideal signature is that of the person the plan is for. Of course a DPOA or legal authority (such as a facility acting as guardian when there is no family) can sign. If the client is able to competently sign a consent form, the plan can still be insurance; otherwise, we would simply do a pre-need trust funeral plan.

Let’s talk Irrevocability.

The term “spend-down” can be a negative concept if we’re spending money just to reduce assets. But final arrangement expenses are inevitable, so they are allowable expenses for Medicaid spend-down and can be a key strategy in sheltering assets in an appropriate and meaningful way.

All funeral, cremation, and cemetery contracts can be made irrevocable, and you can do these in several ways: You could pay the entire amount in full; you could do a lump sum down payment and pay the rest in installments over time; or you can simply pay with payments over time. Payments over time can help maintain a planned, intentional monthly income-expense balance.

Funeral and cemetery contracts should only be irrevocable as part of immediate Medicaid planning. You can make a pre-plan that is revocable and later simply request that it be made irrevocable – so this can always be done later. But once done, it can’t be reversed.

Cost Planning

Florida Statutes 744.441(p): “Pay reasonable funeral, interment, and grave marker expenses for the ward from the ward’s estate.”

A guardian the power to pay reasonable funeral, interment, and grave marker expenses for the from their client’s estate. It’s my understanding (not a guardian – verify) that in pre-planning you have more flexibility in the amount of an irrevocable plan and that there will be more constraints after a death occurs. So, for example, if your client wanted to honor their religious requirement for traditionally burial rather than cremation, you could more easily do this before the death occurs. I would say make sure before planning that you check on expectations, limits, and any issues that you may face when submitting your cost report to the court.

Options for Homeless or Indigent or other Income-constrained Clients

Remember when we talked about Veterans and i mentioned the ALICE report? ALICE, if you recall, stands for Asset-Limited, Income Constrained, but Employed – what we used to call the “working poor”. The ALICE Threshold is a financial threshold above the federal poverty level but below or stretching the ability of the person or family to maintain basic needs such as housing, food, medical care, etc.

In Florida, 55% of households that are headed by someone who is 65 or older are below the ALICE threshold.

I see it every day. I met with a couple recently in their 80’s. The husband is still working Uber so they can make ends meet. They were not able to do the plan they wanted to honor their religious traditions, but they were able to use the provider they trusted and make a plan that was more economical with payments that fit their budget. That won’t be the case for everyone, so here are some options you can share with clients and utilize.

In my own experiences with homelessness and financial challenges i’ve learned that the the biggest thing taken away from you when you don’t have your own resources is your choices.

You should become familiar with what is available to you where you are. Some Florida counties have designated low-cost cremation services for low-income residents. The counties themselves may have free cremation programs for qualified persons (homeless/indigent) that may include scattering or placement in unmarked or designated ground.

There are also free services out there for anatomical donation (donation of the body to science). One option i hear often is the United Tissue Network. The reputation of “free” services isn’t great, but UTN is accredited by the American Association of Tissue Banks. You can do your research on Charity Navigator, ProPublica, the IRS, reading independent reviews and searching for news stories, and other resources to determine if a “free” service is right for you or your client – and it very well may be a better choice than a go-fund-me after the death occurs. Anatomical donation through the Anatomical Board of Florida has strict regulations on the care of decedents and use of human remains; donation through one of these programs can give greater peace of mind, but requires the cost of a funeral home for transportation and preparation of the body for the donation.

Your Deathcare Professional on Speed Dial.

Before we close the discussion i want to offer my services to all Guardians in Florida. I’m licensed throughout Florida if you would like to use a Dignity Memorial provider. My in-person meeting range is Orange and Seminole (though i wander through boundaries a bit…); i can do a virtual consultation for anywhere in the state. Regardless of whether you’re planning with a Dignity location, i’m honored to answer any questions you might have so please reach out anytime.

We can also offer educational seminars about pre-planning, or specifically for Veterans’ Burial Benefits, for any community, church, organization, business – and we provide refreshments! If you’d like to schedule one in your area just let me know.

I’m so grateful for the time to talk with the Guardian Association of Pinellas County about this topic today. You can learn more about membership and their services at https://guardianassociation.org

Connect with me – your friendly deathcare professional – on LinkedIn, or reach out by call/text 407-608-9242, or email tee.rogers@dignitymemorial.com.